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Cited by 18Smoking Behavior and CessationMindfulness and Compassion InterventionsSubstance Abuse Treatment and Outcomes

Effectiveness of mindfulness-based relapse prevention program as an adjunct to the standard treatment for smoking: a pragmatic design pilot study

Weiss de Souza, Isabel Cristina, Kozasa, Elisa Harumi, Bowen, Sarah, Richter, Kimber P, Sartes, Laisa Marcorela Andreoli, Colugnati, Fernando Antônio Basile, Noto, Ana Regina·2020·Nicotine and Tobacco Research
DOI 10.1093/ntr/ntaa057
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Abstract

INTRODUCTION: Posttreatment relapse is a major roadblock to stemming the global epidemic of tobacco-related illness. This article presents results from a pilot trial evaluating the feasibility and initial efficacy of Mindfulness-Based Relapse Prevention (MBRP) as an adjunct to standard relapse prevention treatment (ST) for smoking cessation. AIMS AND METHODS: Smokers (n = 86) in the maintenance phase of treatment were randomized to receive either ST plus MBRP (MBRP) (n = 44) or ST alone (ST) (n = 42). Data were collected at baseline and at 4-, 12-, and 24-week follow-up points. We evaluated the feasibility of the protocol with frequency analysis, and the efficacy with both intention to treat and complete case analyses of the effects of MBRP on abstinence. Secondary outcomes included mindfulness, craving, depression, anxiety, and positive/negative affect. RESULTS: High adherence suggested MBRP is acceptable and feasible. Participants in the MBRP group reported increases in mindfulness (M = -7.833, p = .016), and reductions in craving (M = 17.583, p = .01) compared with the ST group. Intention to treat analysis found that, compared with MBRP (36.4%), ST (57.1%) showed trend-level superiority in abstinence at Week 4 (Prevalence Ratio = 0.63, p = .06); however at Week 24, the ST group (14.3%) demonstrated a twofold greater decrease in abstinence, compared with the MBRP group (20.1%) (Prevalence Ratio = 2.25, p = .08). Therefore, the MBRP group maintained a higher abstinence rate for longer. Reported effects were greater in the complete case analysis. CONCLUSIONS: MBRP holds promise for preventing relapse after aided tobacco quit attempts. IMPLICATIONS: Findings suggest that MBRP is acceptable, feasible, and valued by participants. At 24-week follow-up, there was a large effect size and a statistical trend toward fewer MBRP patients relapsing compared with ST patients. MBRP conferred ancillary benefits including reductions in craving and increases in levels of mindfulness. MBRP for tobacco cessation is highly promising and merits further research. TRIAL REGISTRATION: clinicaltrials.gov. IDENTIFIER: NCT02327104.

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  • One study comparing mindfulness-based relapse prevention with no treatment had a point estimate favouring the intervention but substantial imprecision (RR 1.43, 95% CI 0.56 to 3.67; 86 participants; very low-certainty evidence).

    “de Souza 2020's point estimate favoured mindfulness‐based relapse prevention over no treatment but there was substantial imprecision, meaning the result could indicate potential harm as well as considerable benefit (RR 1.43, 95% CI 0.56 to 3.67; 86 participants; very low‐certainty evidence; Analysis 1.4).”

    From Mindfulness for smoking cessation (2022) · cites this paper as de Souza 2020

  • de Souza 2020 observed no statistically significant or clinically meaningful difference between conditions for depression, anxiety, negative affect, or positive affect at 4 and 12 weeks.

    “No statistically significant or clinically meaningful difference between conditions was observed for any outcome at either time point.”

    From Mindfulness for smoking cessation (2022) · cites this paper as de Souza 2020

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Authors
Weiss de Souza, I. C., Kozasa, E. H., Bowen, S., Richter, K. P., Sartes, L. M. A., Colugnati, F. A. B., & Noto, A. R.
Affiliations
  • Departamento de Psicobiologia, Universidade Federal de São Paulo , São Paulo, SP,
  • Hospital Israelita Albert Einstein (BR)
  • Pacific University Oregon (US)
  • University of Kansas (US)
  • Universidade Federal de Juiz de Fora (BR)
  • Universidade Federal de São Paulo (BR)
ORCID
Venue
Nicotine and Tobacco Research
Publisher
Oxford University Press (OUP)
Published
2020-03-28
Volume
22
Issue
9
Pages
1605-1613
ISSN
  • 1462-2203 (ISSN-L)
  • 1469-994X
DOI
10.1093/ntr/ntaa057
OpenAlex
W3013650631
Cited by
18
References
50
Citations by year
2026: 2 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 1 · 2020: 2
FWCI
1.35
Type
journal article
Language
en
Open access
closed
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor, 1 d)
Locations
  • Nicotine & Tobacco Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Public call MCT/CNPq/MEC/CAPES
  • Casadinho/Procad
  • Programa de Apoio a Núcleos Emergentes de Pesquisa (PRONEM)/FAPEMIG
  • Fundação de Amparo à Pesquisa do Estado de São Paulo
  • Development line—Regular programs/research aid
  • Doctoral Fellowship CNPq
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
mindfulness-based relapse prevention, smoking cessation, abstinence maintenance, craving, mindfulness, adjunctive therapy, feasibility, tobacco use disorder, anxiety and depression
MeSH terms
Tobacco Smoking, Adult, Brazil, Female, Humans, Male, Middle Aged, Pilot Projects, Recurrence, Cognitive Behavioral Therapy, Secondary Prevention, Mindfulness, Craving

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